Abstract Body (Do not enter title and authors here): Background:
Hypertrophic obstructive cardiomyopathy (HOCM) is a genetic disorder characterized by thickened heart muscle and dynamic left ventricular outflow tract (LVOT) obstruction. Mavacamten (Camzyos) is a novel therapeutic agent targeting myocardial contractility. This study evaluates the impact of Mavacamten on blood pressure (BP) and other clinical parameters in HOCM patients over a 24-month period.
Methods:
A retrospective study was conducted on 40 HOCM patients initiated on Mavacamten, with follow-ups at 12 and 24 months. Blood pressure measurements (systolic BP [SBP] and diastolic BP [DBP]) were recorded at baseline, 12 months, and 24 months. Secondary outcomes included changes in LVOT obstruction at rest and with provocation, the New York Heart Association (NYHA) functional class, and left ventricular ejection fraction (LVEF).
Results:
The study population had a mean age of 67 ± 10 years, with 50% male. Baseline characteristics included a high prevalence of hypertension (78%), dyslipidemia (67%), and atrial fibrillation (31%). At 12 and 24 months, there were no significant changes in SBP (137 ± 18 mmHg to 139 ± 18 mmHg at 12 months, p=0.850, and to 132 ± 17 mmHg at 24 months, p=0.607) or DBP (78 ± 11 mmHg to 80 ± 10 mmHg at 12 months, p=0.409, and to 80 ± 10 mmHg at 24 months, p=0.468). However, significant reductions were observed in LVOT pressure gradients both at rest (48 ± 41 mmHg to 11 ± 15 mmHg at 12 months, p<0.001, and to 8 ± 13 mmHg at 24 months, p<0.001) and with provocation (89 ± 59 mmHg to 27 ± 32 mmHg at 12 months, p<0.001, and to 22 ± 28 mmHg at 24 months, p<0.001). NYHA class improved significantly, with a higher proportion of patients in class I (3% to 21% at 12 months, p=0.031, and to 27% at 24 months, p=0.016) and a reduction in class III patients (50% to 12% at 12 months, p<0.001, and to 10% at 24 months, p=0.002). LVEF decreased from 69 ± 6% to 64 ± 4% at 12 months (p<0.001) and remained at 64 ± 6% at 24 months (p<0.001).
Conclusion: Mavacamten use in HOCM patients over 24 months demonstrated stability in blood pressure but significant improvements in LVOT obstruction, NYHA functional class, and a slight decrease in the LVEF.